Sunday, November 3, 2013

debt and burnout

These are two subjects that (almost) every medical student struggles with, but is afraid to talk about, even (or perhaps especially) with her med school classmates. I bring them up because I feel like both are topics that need to be addressed, and I would really like to get to the bottom of how we got here and what can we do about it now? I've chosen to link to two articles that specifically address these problems well, because I think they have a broader perspective than I could share.
Debt. Ugh. It's kind of the huge (more like gigantic) elephant in the closet, isn't it? I mean, I try to ignore it, I try to live my life in a conscientious way without stressing about money, but whenever I make a purchase over $5 - or even an unnecessary $3 purchase, like coffee - I think about how I am actually paying a significant amount of interest on that coffee or that toy for my cat. It is a constant burden that I would love to ignore but I would also be stupid to ignore - kind of a catch 22. I wanted to share this article about medical school debt and the path to becoming a doctor because 1) I don't have time to write something like this right now and 2) I think it's important to see the perspective of someone who has completed his training.

Note: I actually have no idea what this says... 
Burnout/mental health. Because I'm a person who has to talk about my feelings, profusely, to my friends, I feel lucky that sharing my struggles with depression and insecurity with my medical school friends has helped me to know I am not alone. I would be very surprised if I had a single friend who hasn't already dreamed about, let alone seriously considered, dropping out of medical school. This article  refers to a study that found that over half of medical students (I emphasize med students because this is really only the first half of our medical training) meet the criteria for burn out, and if anything, I would say this is an underestimation.

So how did we get here? What can we do about it now?

I think first we need to have physician voices willing to say that the burdens are too big and the stakes are too high. We need to have people willing to advocate for us and say that we need better loan options and better ways to fund medical education. I think it's mentally and financially healthier to have no debt and a smaller salary down the road, as is the case in many other nations.

I think it's important for medical schools not only to provide passive mental health care (ie where counseling is made somewhat available), but for medical schools and medical students to take an active role in prompting discussions about stress and burnout, and providing easily accessible options that aren't financially burdensome.

I don't have a perfect picture of what the solutions to these problems looks like, or how to get there. But the first step is just to bring them up.